ENDARTERECTOMY RESULTS IN CORONARY ARTERY BYPASS GRAFT SURGERY: EARLY POSTOPERATIVE OUTCOME AND MEDIUM-TERM SURVIVAL IN 96 CAD PATIENTS WITH ENDARTERECTOMY AND 2339 PATIENTS UNDERGOING CABG

Background- A small proportion of patients undergoing coronary artery bypass ‎surgery had endarterectomy of one or more vessels. Patients characteristics, early ‎postoperative outcome, and mid-term survival in endarterectomy bypass surgery ‎patients were investigated‏.‏‎
‎ Methods- A total of 2339 consecutive patients undergoing isolated CABG from April ‎‎2002 to May 2003 were studied, 4% of whom had endarterectomy. Demographic and ‎periprocedural data were registered retrospectively in a computerized institutional ‎database. Results- The endarterectomy CABG group was younger and included a ‎higher proportion of females, and patients with diabetes, hypertension, lower ejection ‎fraction, triple vessel disease and unstable angina. They required longer cross-clamp ‎and cardiopulmonary bypass times‏.‏‎
‎ Intensive care unit and hospital stays were prolonged and blood product transfusions, ‎need for inotropic support and/or intra-aortic balloon-pump was higher in ‎endarterectomy patients‏.‏ Perioperative mortality (30 days) was 6.25% vs. 3.5%. Cumulative one-year survival ‎was 79% versus 86.2% (p<0.001).‎ ‎
‎ Conclusions- Short-term mortality was almost two-fold in endarterectomy patients ‎after CABG and they had increased postoperative mortality in comparison with ‎regular CABG patients, particularly with regard to bleeding and infections. One-year ‎survival was impaired in endarterectomy patients, mainly because of a less-favorable ‎outcome and early closure of grafts (Iranian Heart Journal 2002, 2003; 3(4&4(t): 56-‎‎60). ‎